زیرشاخه پژوهشیدندانپزشکی کودکان
مقالهها، منابع و پژوهشهای تازه حوزه دندانپزشکی کودکان
جستوجوی چندمنبعی
PubMed2026
Journal of the Indian Society of Pedodontics and Preventive DentistryYash Bafna, Shahid Shaikh, Shobha Fernandes
BACKGROUND: Molar-incisor hypomineralization (MIH) is associated with hypersensitivity and resistance to local anesthesia (LA), which complicates treatment in children. No nationwide study has examined the frequency of these anesthetic challenges among pediatric dentists or their association with clinician stress and burnout. The aim of the study was to assess the prevalence of LA inadequacy in MIH-affected teeth and its relationship with stress, burnout, and job satisfaction among pediatric dentists. MATERIALS AND METHODS: A cross-sectional online survey was conducted among qualified pediatric dentists across India using a validated questionnaire. Convenience and snowball sampling yielded 100 complete responses after exclusion. The instrument covered sociodemographics, MIH clinical experience, anesthetic difficulties, escalation practices, and well-being (modified Mini Copenhagen Burnout Inventory). Data were analyzed using descriptive statistics, nonparametric tests, Chi-squared tests, Spearman correlations, and multivariable linear regression adjusted for confounders. RESULTS: Most respondents reported routine LA inadequacy in MIH cases, commonly with supplemental buccal infiltration and intraligamentary injections. Higher perceived LA failure was strongly associated with treatment postponement, extraction, and general anesthesia referral. MIH-related anesthetic stress was strongly correlated with higher burnout and lower job satisfaction. Multivariate analysis identified elevated MIH workload, corporate/private college settings, and longer experience as independent predictors of poorer well-being. CONCLUSION: LA challenges in MIH management are prevalent among Indian pediatric dentists and significantly contribute to occupational stress and burnout. Targeted training in adjunctive techniques and institutional wellness support are recommended to improve clinician resilience and patient care.
PubMed2026
Annals of plastic surgerySerena N Kassam, Daniela Garib, Maria Costanza Meazzini
Challenges in orthodontic management for patients with cleft lip and palate (CLP) center on facial growth deficiencies and oral health. Patients with complete CLP exhibit maxillary arch constriction from an early age, typically more severe in the canine region than in the molar region. Transverse management centers on the maxillary arch and types of expansion. The ability to provide targeted anterior expansion while simultaneously addressing posterior crossbites is crucial for correcting arch constriction in patients with cleft lip and palate. Maxillary constrictions are usually addressed immediately prior to the secondary alveolar bone graft procedure. The instability of maxillary expansion in CLP patients is one reason why expansion is often performed early. Anteroposterior (sagittal) orthopedic management of maxillary deficiencies in patients with CLP still remains a challenge, with decisions on treatment based on timing, indications, and severity. A protocol is presented with favorable results for complicated cases. Early correction of the hypoplastic maxilla in patients with CLP is notoriously followed by substantial skeletal relapse; consequently, protraction undertaken in the deciduous or early-mixed dentition should be reserved for cases in which marked functional impairment, such as hipoacusia, is present. Conversely, when the same orthopedic stimulus is applied in proximity to the pubertal growth spurt, the skeletal correction tends to be considerably more stable. Challenges in pediatric dentistry persist with poor oral hygiene and caries. Without a foundation for stable dentition, the best of orthodontic treatment planning can be compromised. Despite awareness on importance of oral health as it relates to systemic conditions and the additional factors faced with CLP patients, more follow-up is needed. Prevention and frequent follow-up with the pediatric dentist are key.
PubMed2026
General dentistryCarolyn Griffin, Qingzhao Yu, Nubaira Rizvi, Richard W Ballard, Paul C Armbruster
This study evaluated and compared the perceptions of general dentists, pediatric dentists, and orthodontists regarding the need for transverse maxillary expansion for Class I malocclusions with posterior crossbite. An electronic survey consisting of digitally manipulated intraoral images depicting 8 clinical scenarios was distributed to 10,000 general dentists, 8734 pediatric dentists, and 2400 orthodontists. A total of 566 practitioners responded (2.7% response rate): 85 general dentists, 339 pediatric dentists, and 142 orthodontists. For each case, participants assessed the need for expansion, type of expansion, and referral preferences. Statistical analyses included chi-square tests and multivariable logistic regression, which were adjusted for specialty, years of experience, and geographic region. Significant differences in perception were observed in 6 of the 8 cases (P < 0.05), primarily influenced by specialty training. Orthodontists demonstrated significantly higher odds of recommending expansion than general dentists, particularly in more complex presentations. Pediatric dentists more frequently opted for referral rather than treatment. Neither years of practice nor geographic region significantly influenced diagnostic decisions. Survey reliability demonstrated moderate to substantial agreement across repeated cases (κ = 0.424 to 0.677), and power analysis indicated sufficient sample size and effect sizes for most scenarios. These findings suggest that specialty training strongly influences the perceived need for transverse maxillary expansion, highlighting a potential need for enhanced orthodontic diagnostic education in dental and pediatric residency programs to promote consistency in the diagnosis and management of transverse discrepancies across dental specialties.